Case Analysis #2: Patty – Anorexia Nervosa
After reading the case example of Patty, complete the questions below in a readable, colored font. These questions are designed to help you apply the theoretical explanations for the disorder. We will be discussing these during class as well as expanding upon them so you might benefit from bringing a copy of your responses to class for the discussion.

1. Many people do not understand the full consequences of suffering from Anorexia Nervosa. What are two of the more serious medical consequences Patty experienced as a result of her Anorexia Nervosa? (1pt) As a result of her Anorexia Nervosa, Patty stopped menstruating for several months, known as amenorrhea. Additionally, Patty developed signs of cardiac problems, such as low pulse rate and loss of bone density.

2. What seemed to be a primary “trigger” for Patty’s Anorexia Nervosa? (1pt) A primary trigger for Patty’s eating disorder was distress that stemmed from her social life. She parted ways with a lifelong friend and found out her ex-boyfriend was sexually unfaithful to her.

3. What aspect of the biopsychosocial model (physical, cognitive, psychological/emotional, or sociocultural) does the trigger you identified in question 2 fit into, AND, explain why it might bring on the desire to severely restrict eating? (2pt) This trigger fits into the psychological/emotional aspect. The loss of a friend and a relationship can easily cause emotional stress leading to an eating disorder. This may bring on the desire to severely restrict eating because it reduces the feelings of stress and low-self esteem while increasing the feelings of self-control and accomplishment.

4. Certain anxiety disorders, such as OCD, commonly co-occur with Anorexia Nervosa. Identify one example of how Patty’s symptoms mimic the pattern of an anxiety disorder and describe how it is similar. (1pt) The compulsive aspect of OCD, as written in my notes, is “repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety.” In Patty’s case, focusing on exercise and weight loss reduces the distressing emotions that stem from her social life. She runs multiple miles per day, goes to swim practice, and runs at night while her family is sleeping. Excessive exercise is a voluntary act she is using to reduce her stress.

5. Given the information you have, what family environment factors do think may be operating to influence Patty’s symptoms (be sure you can draw a connection between the family pieces and specific symptoms). (1pt) Patty had a sister that is 2 years older. Although Patty was a smart A and B student, she did not feel that she was as strong of a student as her sister who had all A’s and was valedictorian of her high school. With these high standards set for Patty, perfectionism and self criticism could have stemmed from having a sister’s footsteps to follow in. A loss of control with schoolwork standards may have led to the extreme “control” of food. Patty’s relationship may have an additional factor with her symptoms. Her family was extremely close. Patty and her sister decided to go to college only 20 miles from home, which apparently was “too far” for her mother. The symptom of taking control over food may have also stemmed from this, as she may have an overprotective mother to begin with.

6. Describe an example of how Patty’s Anorexia symptoms were reinforced both through positive reinforcement and negative reinforcement (e.g., application of behavioral theory). (2pts) Negative Reinforcement: Distressing emotions were reduced when she focused on exercising and weight loss. Since the feeling of stress is removed as a result of her behavior, the behavior increases because it creates the outcome she desires.

Positive Reinforcement: An obvious positive reinforcer for Patty was attention. Two of Patty’s friends contacted her ex-boyfriend expressing their concern. The attention she received from him contacting her reinforced her to continue her behavior. He was part of the initial reason for her onset of the eating disorder, so hearing from him pleases her.

7. What is one example of a cognitive factor contributing to the development of eating disorders that Patty clearly showed? (1pt) A cognitive factor that contributed to Patty’s development of anorexia was her preoccupation with weight and food. Patty was slightly underweight to begin with, yet became over concerned about losing more and more weight. Thoughts about weight and food interfered with her ability to concentrate.

8. How is Patty’s case example of Anorexia Nervosa similar to AND different from the understanding you had from media/other sources prior to reading this chapter? Note: you must identify an example of both as I expect you found something new/interesting that you did not know before. (1pt) Similar: Prior to reading this chapter, I knew that Anorexia Nervosa had serious medical consequences. Like Patty, I have seen friends from high school end up in treatment clinics because of their weight loss and the effect it has on overall health. Different: Patty’s case also provided me with a different understanding of how an eating disorder may arise. When I think of eating disorders triggers, I imagine girls flipping through magazines of models with the desire to become bone thin. However, this is not always the case. Like Patty, an eating disorder can be triggered by a emotional response to a social event. It’s not always about wanting to look like a model in a magazine.